ObjectiveBased on ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry（UPLC-Q-TOF-MS^E） technique， we identified qualitatively the metabolites of aristolochic acid（AAs） in rat in order to analyze the metabolic differences between water extract of Aristolochiae fructus（AFE） and Aristolochic acid Ⅰ（AAⅠ）. MethodSD rats were selected and administered AFE（110 g·kg^-1·d^-1） or AAⅠ（5 mg·kg^-1·d^-1） by oral for 5 days， respectively. Serum， urine and feces were collected after administration. Through sample pretreatment， ACQUITY UPLC BEH C₁₈ column（2.1 mm×100 mm， 1.7 μm） was used with the mobile phase of 0.01% formic acid methanol（A）-0.01% formic acid water（B， containing 5 mmol·L^-1 ammonium acetate） for gradient elution（0-1 min， 10%B； 1-7 min， 10%-75%B； 7-7.2 min， 75%-95%B； 7.2-10.2 min， 95%B； 10.2-10.3 min， 95%-10%B； 10.3-12 min， 10%B） at a flow rate of 0.3 mL·min^-1. Positive ion mode of electrospray ionization（ESI⁺） was performed in the scanning range of m/z 100-1 200. In combination with UNIFI 1.9.4.053 system， the Pathway-MS^E was used to qualitatively analyze and identify the AAs prototype and related metabolites in biological samples（serum， urine and feces）， and to compare the similarities and differences of metabolites in rats in the subacute toxicity test between AFE group and AAⅠ group. ResultCompared with AAⅠ group， 6， 10， 13 common metabolites and 14， 20， 30 unique metabolites were identified in biological samples（serum， urine and feces） of AFE group， respectively. Moreover， the main AAs components always followed the metabolic processes of demethylation， nitrate reduction and conjugation. Compared with common metabolites in AAⅠ group， prototype components of AAⅠ in serum and most metabolic derivatives of AAⅠ［AAⅠa， aristolochic lactam Ⅰ（ALⅠ）a， 7-OHALⅠ and its conjugated derivatives］ in biological samples were significantly increased in AFE group（P<0.05， P<0.01）， except that the metabolic amount of ALⅠ in feces of AFE group was remarkably lowed than that of AAⅠ group（P<0.01）. In addition， a variety of special ALⅠ efflux derivatives were also identified in the urine and feces of the AFE group. ConclusionAlthough major AAs components in AFE all show similar metabolic rules as AAⅠ components in vivo， the coexistence of multiple AAs components in Aristolochiae Fructus may affect the metabolism of AAⅠ， and achieve the attenuating effect by increasing the metabolic effection of AAⅠ and ALⅠ.

Objective: To study the incidence of bloodstream infections, pathogen distribution, and antibiotic resistance profile in patients with hematological malignancies. Methods: From January 2018 to December 2021, we retrospectively analyzed the clinical characteristics, pathogen distribution, and antibiotic resistance profiles of patients with malignant hematological diseases and bloodstream infections in the Department of Hematology, Nanfang Hospital, Southern Medical University. Results: A total of 582 incidences of bloodstream infections occurred in 22,717 inpatients. From 2018 to 2021, the incidence rates of bloodstream infections were 2.79%, 2.99%, 2.79%, and 2.02%, respectively. Five hundred ninety-nine types of bacteria were recovered from blood cultures, with 487 (81.3%) gram-negative bacteria, such as Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. Eighty-one (13.5%) were gram-positive bacteria, primarily Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecium, whereas the remaining 31 (5.2%) were fungi. Enterobacteriaceae resistance to carbapenems, piperacillin/tazobactam, cefoperazone sodium/sulbactam, and tigecycline were 11.0%, 15.3%, 15.4%, and 3.3%, with a descending trend year on year. Non-fermenters tolerated piperacillin/tazobactam, cefoperazone sodium/sulbactam, and quinolones at 29.6%, 13.3%, and 21.7%, respectively. However, only two gram-positive bacteria isolates were shown to be resistant to glycopeptide antibiotics. Conclusions: Bloodstream pathogens in hematological malignancies were broadly dispersed, most of which were gram-negative bacteria. Antibiotic resistance rates vary greatly between species. Our research serves as a valuable resource for the selection of empirical antibiotics.
Humans ; Bacteremia/epidemiology* ; Cefoperazone ; Sulbactam ; Retrospective Studies ; Drug Resistance, Bacterial ; Microbial Sensitivity Tests ; Hematologic Neoplasms ; Sepsis ; Anti-Bacterial Agents/pharmacology* ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Piperacillin, Tazobactam Drug Combination ; Escherichia coli

Objective: To evaluate the consistency of patient-completed and physician-completed Caprini scores. Methods: This study was a diagnostic study. We prospectively recruited 200 inpatients (including respiratory and critical care medicine, rheumatology and immunology, obstetrics and gynecology, and orthopedics). Clinical data of the recruited patients were collected. The Wechat applet was developed based on the Chinese version of the patient-completed Caprini score. Patient could enter the Wechat applet by scanning the QR code, and enter the height, weight and other contents to the Wechat applet. The applet could automatically calculate the score and make the risk stratification according to total score. At the same time, physicians would calculate the traditional Caprini score for the same patient and make risk stratification to evaluate the consistency of scores derived from the two methods. Results: The average age of these 200 patients was (59.6±13.9) years, 112(56.0%) of them were female and 184(92.0%) with high school education or above. There was no significant difference between the patient-completed and physician-completed scores (4.8±2.5 vs. 4.7±2.5,P=0.336). The time of physician-completed score was shorter than that of patient-completed score ((2.0±1.0) minutes vs.(2.4±1.2) minutes, P<0.000 1). There was no significant difference on the number of high-highest venous thromboembolism risk patients assessed by the patient-completed and the physician-completed scores: 84.5% (169/200) vs. 83.0%(166/200)(χ²=0.165, P=0.684).There was strong positive correlations between patient-completed and physician-completed scores (r=0.98, P<0.000 1). Cohen's ĸ evaluation showed that the patient-completed Caprini score was in excellent consistency with physician-completed Caprini score(κ=0.97,P<0.000 1). The result of Bland Altman method showed that only 3.0% (6/200) of the scores biased greatly, which was not within the 95% confidence interval, the result proved that the bias belonged to a small probability event. It was inferred that the scores of patient-completed were consistent with those of the physician-completed. Conclusions: The patient-completed Caprini score is in good agreement with the physician-completed Caprini score in this patient cohort.
Aged ; Cohort Studies ; Female ; Humans ; Male ; Middle Aged ; Physicians ; Retrospective Studies ; Risk Assessment/methods* ; Risk Factors ; Venous Thromboembolism

With the aging process of population in the society, the prevalence of cardiovascular diseases (CVD) in China is increasing continuously and the number of dental patients with CVD is increasing gradually too. Due to the lack of guidelines for dental patients with CVD in our country, how to implement standardized preoperative evaluation and perioperative risk prevention remains a problem to be solved for dentists at present. The present expert consensus was reached by combining the clinical experiences of the expert group of the Fifth General Dentistry Special Committee, Chinese Stomatological Association and respiratory and cardiology experts in diagnosis and treatment for CVD patients, and by systematically summarizing the relevant international guidelines and literature regarding the relationship between CVD and oral diseases and the diagnosis and treatment of dental patients with heart failure, hypertension and antithrombotic therapy. The consensus aims to provide, for the dental clinicians, the criteria on diagnosis and treatment of CVD in dental patients in China so as to reduce the risk and complications, and finally to improve the treatment levels of dental patients with CVD in China.
Cardiovascular Diseases/prevention & control* ; China/epidemiology* ; Consensus ; Dental Care ; Humans ; Oral Medicine

Objective:To evaluate the value of CT angiography (CTA) in the assessment of risk factors for rupture of intracranial aneurysm (IA).Methods:The clinical and CT imaging data of 46 patients with IA in the Second Affiliated Hospital of Bengbu Medical College from January 2018 to June 2020 were retrospectively analyzed. The morphological parameters of aneurysm were analyzed by CTA post-processing images: aneurysm number, site, morphology, maximum diameter, height/neck width, maximum diameter/parent artery proximal diameter, aneurysm incidence angle. The morphological risk factors of aneurysm rupture were evaluated by univariate analysis and multivariate logistic regression analysis. We used receiver operating characteristics curve (ROC) to evaluate the diagnostic efficacy in predicting aneurysm rupture.Results:A total of 58 aneurysms were detected by CTA, 30 ruptured aneurysms and 28 unruptured aneurysms. There was no statistically significant difference in gender and age between patients with ruptured and unruptured aneurysms ( P>0.05). In the morphological parameters of ruptured and unruptured aneurysms, there were no statistically significant differences in the number, site and height/neck width of aneurysms ( P>0.05), while there were statistically significant differences in aneurysm morphology, maximum diameter, maximum diameter/parent artery proximal diameter and aneurysm incidence angle ( P<0.05). Multivariate logistic regression analysis showed that maximum diameter/parent artery proximal diameter and aneurysm incidence angle were independent risk factors for aneurysm rupture ( P<0.05). ROC curve analysis showed that when the maximum diameter of the tumor / the diameter of the proximal carrying artery >1.985, the area under the curve was 0.748, and the sensitivity and specificity were 76.7% and 64.3%, respectively; When the incidence angle of blood flow was >117.5°, the area under the curve was 0.673, and the sensitivity and specificity were 53.3% and 75.0% respectively. Conclusions:The maximum diameter/parent artery proximal diameter >1.985 and the aneurysm incidence angle >117.5° are independent risk factors for aneurysm rupture.

Cardiovascular disease is the main cause of mortality and morbidity in the world, especially in developing countries. Drug therapy is one of the main ways to treat cardiovascular diseases. Among them, great progress has been made in the treatment of cardiovascular diseases with traditional Chinese medicine. In terms of experimental research, the mechanism of traditional Chinese medicine in the treatment of cardiovascular diseases has been thoroughly discussed in vitro and in vivo. In terms of clinical treatment, traditional Chinese medicine with flavonoids, saponins and alkaloids as the main effective components has a definite effect on the treatment of cardiovascular diseases such as arrhythmia, myocardial ischemia, angina pectoris and myocardial infarction, with high safety and good application prospects. With the further research on the effective ingredients, mechanism and adverse reactions of traditional Chinese medicine, it will be beneficial to the effectiveness of traditional Chinese medicine, reduce side effects and promote the modernization of traditional Chinese medicine. Calycosin and its derivatives, the main bioactive flavonoids in Astragalus membranaceus have multiple biological effects, such as antioxidant, pro-angiogenesis, anti-tumour, and anti-inflammatory effects. Based on the above biological effects, calycosin has been shown to have good potential for cardiovascular protection. The potent antioxidant effect of calycosin may play an important role in the cardiovascular protective potential. For injured cardiac myocytes, calycosin and its derivatives can alleviate the cell damage mainly marked by the release of myocardial enzymes and reduce the death level of cardiac myocytes mainly characterized by apoptosis through various mechanisms. For vascular endothelial cells, calycosin also has multiple effects and multiple mechanisms, such as promoting vascular endothelial cell proliferation, exerting vasodilating effect and directly affecting the synthesis function of endothelial cells. The present review will address the bioactivity of calycosin in cardiovascular diseases such as protective effects on cardiac myocytes and vascular endothelial cells and elucidate main mechanism of calycosin and its derivatives to exert the above biological effects.
Apoptosis/drug effects* ; Cardiotonic Agents/pharmacology* ; Cardiovascular Diseases/drug therapy* ; Cell Proliferation/drug effects* ; Drugs, Chinese Herbal/pharmacology* ; Humans ; Isoflavones/pharmacology* ; Medicine, Chinese Traditional ; Muscle Cells/drug effects*

Objective Circular RNA (CircRNA) plays an important role in the carcinogenesis and development of cancers. However, the relationship between circRNA and nasopharyngeal carcinoma (NPC) has been rarely reported. The aim of this study is to investigate the differentially expressed circRNAs in human NPC and chronic nasopharyngeal mucositis.Methods Three NPC specimens and three chronic nasopharyngeal mucositis specimens which were diagnosed by nasopharyngeal biopsy in the Affiliated Hospital of Guangdong Medical University from November 2016 to March 2017, were enrolled in the study. The circRNA expression profiles of those candidates were assayed by high-throughput human circRNA microarray. After pretreatment and homogenization of the original data, the circRNAs with differential expression were screened out and analyzed by hierarchical clustering. Moreover, Gene Ontology (GO) analysis and KEGG pathway analysis were performed to analyze the functional classification and related pathways.Results Compared with the chronic nasopharyngeal mucositis, there are a total of 829 differentially expressed circRNAs in NPC, among which 761 were found to be up-regulated and 68 were down-regulated. Those differentially expressed circRNAs were analyzed to be mainly related to cell cycle, cell proliferation and other biological processes; mainly involved in p53 signaling pathway, cell cycle and DNA replication signaling pathway.Conclusion Those differentially expressed circRNAs may be associated with the tumorigenesis and development of NPC.

Objective To explore the current status of the prenatal care quality and the influencing factors in Hangzhou City. Methods We used sociodemographic characteristics questionnaire and the Chinese version of QPCQ to investigate 383 pregnancy women who were at 36 weeks' gestation or greater by convenient sampling method from September to December in 2016. Results A total of 350 questionnaires were valid. The average age of 350 samples was (29.71±3.67) years old. There were 231 primiparas which accounted for 66.00％. Among them, 196 (56.00％) were satisfied with the prenatal care they received, and 153 (43.70％) think general, and only 1 (0.30％) felt unsatisfied. The score of the Chinese version of QPCQ was 3.61±0.50. The item "My prenatal care professional (s) always answered my questions honestly" had the highest scores of 4.10±0.62, while "My prenatal care professional (s) did things hastily" had the lowest scores of 2.44±0.96 . By multiple linear regression analysis, those people who had more visiting time (β' = 0.21, P<0.01), less waiting time (β' = -0.18, P<0.01) and the cognition of the essentiality of pregnancy school (β' = 0.12, P=0.02) were more likely to give higher regards for the quality of prenatal care. Conclusion Sufficient time scored relative lower in the whole questionnaire. So, hospitals could take efforts to shorten the waiting time by promoting the hospital process optimization, making good use of this period time and other strategies, so as to improve the quality of prenatal care.

Objective To evaluate the detection value of serum (1,3)-β-D glucan (G-test) and galactomannan (GM-test) combined with sputum fungal culture in the early diagnosis of invasive fungal infection(IFI) in intensive care unit(ICU) patients.Methods Inpatients with high risk factors for IFI in the ICU of the Affiliated Hospital of Xuzhou Medical University between January 2015 and December 2016 were chosen,they were divided into 3 groups according to the diagnostic criteria of IFI:IFI group(including confirmed and clinically diagnosed cases),suspected IFI group,and non-IFI group.The results of serum G-test,GM-test,and sputum fungal culture in three groups of patients were analyzed,early diagnostic value in IFI with combined three tests was evaluated.Results A total of 264 ICU patients were investigated,IFI group,suspected IFI group,and non-IFI group were 56,43,and 165 cases respectively.Among 56 cases of confirmed IFI,46,39,and 34 were positive for G-test,GM-test,and fungal culture respectively.The sensitivity,specificity,positive predictive value,and negative predictive value of combined three detection were 98.2％,82.4％,65.5％,and 99.3％ respectively,positive likelihood ratio,negative likelihood ratio,and Youden index were 5.58,0.02,and 0.98 respectively.The sensitivity and negative predictive values of combined three detection were both higher than those of single G-test,GM-test,and sputum fungal culture (all P＜0.05);but specificity and positive predictive value of combined three detection were not significantly different from single G-test,GM-test,and sputum fungal culture(all P＞0.05).Conclusion The combination of G-test,GM-tests,and sputum fungal culture can improve the sensitivity of early diagnosis of IFI in ICU patients,and guide the clinicians in the early treatment of IFI.